NCT00645918

Brief Summary

The objective of the GRAVITAS trial is to determine whether tailored anti-platelet therapy using the Accumetrics VerifyNow P2Y12 assay reduces major adverse cardiovascular events after drug-eluting stent implantation.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,800

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jun 2008

Typical duration for not_applicable

Geographic Reach
2 countries

82 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 24, 2008

Completed
4 days until next milestone

First Posted

Study publicly available on registry

March 28, 2008

Completed
2 months until next milestone

Study Start

First participant enrolled

June 1, 2008

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2010

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2010

Completed
Last Updated

June 16, 2011

Status Verified

June 1, 2011

Enrollment Period

2.3 years

First QC Date

March 24, 2008

Last Update Submit

June 15, 2011

Conditions

Keywords

PlateletsPlatelet Function TestsClopidogrelDrug Eluting StentsAcute Coronary SyndromeMyocardial IschemiaStent ThrombosisHeart DiseasesCoronary DiseaseArterial Occlusive Disease

Outcome Measures

Primary Outcomes (1)

  • Time to first occurrence of post-randomization CV death, non-fatal MI, or ARC definite/probable stent thrombosis in non-responders randomized to standard vs. tailored dosage

    6 months

Secondary Outcomes (1)

  • Time to first occurrence of post-randomization CV death, non-fatal MI, or ARC definite/probable stent thrombosis in non-responders randomized to standard dosage vs. responders

    6 months

Study Arms (3)

A

ACTIVE COMPARATOR

"Tailored" clopidogrel regimen - an additional clopidogrel 600-mg loading dose (eight 75-mg tablets taken orally; daily 150 mg clopidogrel dose plus additional 450 mg clopidogrel) on the day of randomization and then 150-mg clopidogrel every day thereafter for 6 months.

Drug: clopidogrel

B

PLACEBO COMPARATOR

"Standard" clopidogrel regimen - a placebo loading dose (six placebo tablets taken orally plus daily dose of one placebo tablet plus 75 mg clopidogrel) on the day of randomization followed by one placebo tablet plus 75 mg clopidogrel every day thereafter for 6 months.

Drug: clopidogrelDrug: placebo

C

PLACEBO COMPARATOR

Responders: A random sample of clopidogrel responders treated with a placebo loading dose (six placebo tablets taken orally plus daily dose of one placebo tablet plus 75 mg clopidogrel) on the day of randomization followed by one placebo tablet plus 75 mg clopidogrel every day thereafter for 6 months.

Drug: clopidogrelDrug: placebo

Interventions

oral, 75 mg daily for 6 months starting on day of randomization

ABC

oral, 6 pill loading dose on day of randomization; one pill daily for 6 months starting on day of randomization

BC

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Males or females aged 18 years or older.
  • \. Patients undergoing coronary angiography and possible PCI with planned use of at least one drug-eluting stent (DES), and without planned use of glycoprotein IIb/IIIa inhibitors. One or more bare metal stents (BMS) may be implanted, and other lesions may be treated without stenting, as long as at least one DES is implanted. However, the procedure must be successful and uncomplicated for all lesions (DES + BMS + non stent).
  • Indication for the procedure may be stable angina or ischemia, unstable angina, non-ST elevation MI (NSTEMI), or ST elevation MI (STEMI).
  • Have the ability to understand the requirements of the study, including consent for use and disclosure of research-related health information.
  • Have the ability to comply with study procedures and protocol, including required study visits.
  • \. A female patient is eligible to enter the study if she is (1) of child-bearing potential and not pregnant or nursing; (2) not of child-bearing potential (i.e., has had a hysterectomy, have both ovaries removed, has tubal ligation, or are post-menopausal, defined as 24 months without menses).

You may not qualify if:

  • PCI within previous 30 days.
  • Prior consent to participate in GRAVITAS and not randomized by IVRS.
  • History of gastro-intestinal bleeding within 6 months.
  • Major non-cardiac surgery within 6 weeks.
  • Ischemic stroke within 6 weeks.
  • Any history of hemorrhagic stroke or sub-arachnoid hemorrhage.
  • Other bleeding diathesis, or considered by investigator to be at high-risk for bleeding on long-term clopidogrel therapy.
  • Minor surgical procedures that require cessation of dual anti platelet therapy and result in significant bleeding are NOT eligible.
  • Current or planned therapy with coumadin anticoagulation.
  • Current or planned therapy with other thienopyridine class of ADP receptor inhibitors (e.g., prasugrel, ticlopidine), or the non-thienopyridine ticagrelor.
  • Severe allergy to stainless steel, contrast dye, unfractionated heparin, low molecular weight heparin, or bivalirudin that cannot be adequately pre-medicated.
  • Allergy to aspirin or clopidogrel.
  • Current enrollment in an investigational drug or device study that has not reached the time period of the primary endpoint.
  • Have received GPIIb/IIIa inhibitors eptifibatide or tirofiban within 24 hours before or during PCI or abciximab within 10 days before or during PCI.
  • Thrombocytopenia (defined as platelet count \< 100 K).
  • +11 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (82)

University of Alabama at Birmingham

Birmingham, Alabama, 35233, United States

Location

Scottsdale Health Care - Osborn Campus

Scottsdale, Arizona, 85258, United States

Location

Scottsdale Health Care - Shea Campus

Scottsdale, Arizona, 85258, United States

Location

Scripps Green Hospital

La Jolla, California, 92037, United States

Location

El Camino Hospital

Mountain View, California, 94040, United States

Location

UC Davis Medical Center

Sacramento, California, 95817, United States

Location

Sacramento Heart and Vascular Research Center

Sacramento, California, 95825, United States

Location

UCSD Medical Center

San Diego, California, 92103, United States

Location

Alvarado Hospital

San Diego, California, 92120, United States

Location

San Francisco General Hospital

San Francisco, California, 94110, United States

Location

UCSF Moffitt-Long Hospital

San Francisco, California, 94143, United States

Location

Santa Barbara Cottage Hospital

Santa Barbara, California, 93105, United States

Location

Torrance Memorial Medical Center

Torrance, California, 90503, United States

Location

Bridgeport Hospital

Bridgeport, Connecticut, 06610, United States

Location

Danbury Hospital

Danbury, Connecticut, 06810, United States

Location

Christiana Care Hospital

Newark, Delaware, 19718, United States

Location

Washington Hospital Center

Washington D.C., District of Columbia, 20010, United States

Location

Clearwater Cardiovascular and Interventional Consultants

Clearwater, Florida, 33756, United States

Location

University of Florida Health Science Center

Jacksonville, Florida, 32209, United States

Location

Cardiology Research Associates

Ormond Beach, Florida, 32174, United States

Location

Tallahassee Memorial Hospital

Tallahassee, Florida, 32308, United States

Location

St. Joseph's Research Institute

Atlanta, Georgia, 30342, United States

Location

Redmond Regional Medical Center

Rome, Georgia, 30165, United States

Location

Jesse Brown VA Medical Center

Chicago, Illinois, 60612, United States

Location

University of Illinois Medical Center

Chicago, Illinois, 60612, United States

Location

Trinity Medical Center

Moline, Illinois, 61265, United States

Location

Prairie Education & Research Cooperative

Springfield, Illinois, 62701, United States

Location

St. Vincent Heart Center of Indiana/The Care Group LLC

Indianapolis, Indiana, 46290, United States

Location

Ochsner Clinic Foundation

New Orleans, Louisiana, 70232, United States

Location

Union Memorial Hospital

Baltimore, Maryland, 21218, United States

Location

Washington Adventist Hospital

Takoma Park, Maryland, 20912, United States

Location

Boston University Medical Center

Boston, Massachusetts, 02118, United States

Location

The Lahey Clinic

Burlington, Massachusetts, 01803, United States

Location

Baystate Medical Center

Springfield, Massachusetts, 01199, United States

Location

Cardiac and Vascular Research Center of Northern Michigan

Petoskey, Michigan, 49770, United States

Location

William Beaumont Hospital

Royal Oak, Michigan, 48073, United States

Location

St. Joseph's Mercy Hospital

Ypsilanti, Michigan, 48197, United States

Location

St. Mary's Duluth Clinic Health System

Duluth, Minnesota, 55805, United States

Location

St. Luke's / Mid America Heart Institute

Kansas City, Missouri, 64111, United States

Location

Dartmouth-Hitchcock Medical Center

Lebanon, New Hampshire, 03756, United States

Location

Lenox Hill Hospital

New York, New York, 10021, United States

Location

NY Presbyterian / Weill Cornell Medical Center

New York, New York, 10021, United States

Location

Hudson Valley Heart Center

Poughkeepsie, New York, 12601, United States

Location

Stony Brook University Medical Center

Stony Brook, New York, 11794, United States

Location

Durham VA Medical Center

Durham, North Carolina, 27705, United States

Location

Carolina Cardiology Associates

High Point, North Carolina, 27262, United States

Location

Wake Heart Research

Raleigh, North Carolina, 27610, United States

Location

Wake Forest University

Winston-Salem, North Carolina, 27157, United States

Location

The Lindner Clinical Trial Center

Cincinnati, Ohio, 45219, United States

Location

University Hospitals Case Medical Center

Cleveland, Ohio, 44106, United States

Location

North Ohio Research, Ltd.

Elyria, Ohio, 44035, United States

Location

Cleveland Cardiovascular Research Foundation

Fairview Park, Ohio, 44126, United States

Location

University of Oklahoma Health Science Center

Oklahoma City, Oklahoma, 73104, United States

Location

Oklahoma Cardiovascular Associates

Oklahoma City, Oklahoma, 73120, United States

Location

Geisinger Clinic - Cardiology

Danville, Pennsylvania, 17822, United States

Location

St. Vincent Health Center

Erie, Pennsylvania, 16502, United States

Location

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Geisinger Wyoming Valley Medical Center

Wilkes-Barre, Pennsylvania, 18711, United States

Location

Rhode Island Hospital

Providence, Rhode Island, 02903, United States

Location

The Miriam Hospital

Providence, Rhode Island, 02906, United States

Location

AnMed Health

Anderson, South Carolina, 29621, United States

Location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

Black Hills Clinical Research Center

Rapid City, South Dakota, 57701, United States

Location

Centennial Medical Center

Nashville, Tennessee, 37203, United States

Location

Vanderbilt University Medical Center

Nashville, Tennessee, 37232, United States

Location

South Austin Hospital

Austin, Texas, 78704, United States

Location

Austin Heart P.A.

Austin, Texas, 78756, United States

Location

Baylor Heart and Vascular Hospital

Dallas, Texas, 75226, United States

Location

Plaza Medical Center of Fort Worth

Fort Worth, Texas, 76104, United States

Location

The Methodist Hospital

Houston, Texas, 77030, United States

Location

University Hospital San Antonio (UTHSCSA)

San Antonio, Texas, 78229, United States

Location

Tomball Regional Hospital

Tomball, Texas, 77375, United States

Location

Royal Alexandra Hospital

Edmonton, Alberta, Canada

Location

McMaster University

Hamilton, Ontario, Canada

Location

York PCI Group

Newmarket, Ontario, Canada

Location

University of Ottawa Heart Institute

Ottawa, Ontario, Canada

Location

St. Michael's Hospital

Toronto, Ontario, M5B 1W8, Canada

Location

Centre Hospitalier de l'Université de Montréal (CHUM) Hôtel-Dieu

Montreal, Quebec, Canada

Location

Hôpital du Sacré-Coeur de Montréal

Montreal, Quebec, Canada

Location

Montréal Heart Institute

Montreal, Quebec, Canada

Location

Royal Victoria Hospital

Montreal, Quebec, Canada

Location

Hôpital Laval

Québec, Quebec, Canada

Location

Related Publications (3)

  • Price MJ, Angiolillo DJ, Teirstein PS, Lillie E, Manoukian SV, Berger PB, Tanguay JF, Cannon CP, Topol EJ. Platelet reactivity and cardiovascular outcomes after percutaneous coronary intervention: a time-dependent analysis of the Gauging Responsiveness with a VerifyNow P2Y12 assay: Impact on Thrombosis and Safety (GRAVITAS) trial. Circulation. 2011 Sep 6;124(10):1132-7. doi: 10.1161/CIRCULATIONAHA.111.029165. Epub 2011 Aug 29.

  • Price MJ, Berger PB, Teirstein PS, Tanguay JF, Angiolillo DJ, Spriggs D, Puri S, Robbins M, Garratt KN, Bertrand OF, Stillabower ME, Aragon JR, Kandzari DE, Stinis CT, Lee MS, Manoukian SV, Cannon CP, Schork NJ, Topol EJ; GRAVITAS Investigators. Standard- vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention: the GRAVITAS randomized trial. JAMA. 2011 Mar 16;305(11):1097-105. doi: 10.1001/jama.2011.290.

  • Price MJ, Berger PB, Angiolillo DJ, Teirstein PS, Tanguay JF, Kandzari DE, Cannon CP, Topol EJ. Evaluation of individualized clopidogrel therapy after drug-eluting stent implantation in patients with high residual platelet reactivity: design and rationale of the GRAVITAS trial. Am Heart J. 2009 May;157(5):818-24, 824.e1. doi: 10.1016/j.ahj.2009.02.012.

MeSH Terms

Conditions

Coronary Artery DiseaseAcute Coronary SyndromeMyocardial IschemiaHeart DiseasesCoronary DiseaseArterial Occlusive Diseases

Interventions

Clopidogrel

Condition Hierarchy (Ancestors)

Cardiovascular DiseasesArteriosclerosisVascular Diseases

Intervention Hierarchy (Ancestors)

TiclopidineThienopyridinesThiophenesSulfur CompoundsOrganic ChemicalsPyridinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-Ring

Study Officials

  • Matthew J Price, M.D.

    Scripps Advanced Clnical Trials

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY

Study Record Dates

First Submitted

March 24, 2008

First Posted

March 28, 2008

Study Start

June 1, 2008

Primary Completion

October 1, 2010

Study Completion

October 1, 2010

Last Updated

June 16, 2011

Record last verified: 2011-06

Locations